超声引导下前锯肌平面二次阻滞对胸腔镜下肺部分切除术后镇痛的影响OA

Objective To investigate the effects of ultrasound-guided second serratus anterior plane block(SAPB)on postoperative analgesia,recovery quality,and inflammatory response in patients undergoing thoracoscopic surgery.Methods A total of 86 patients who underwent elective thoracoscopic surgery in Xiaogan Central Hospital from August 2022 to June 2023 were selected and randomly divided into the serratus anterior plane block(SAPB)group(n=43)and the control group(n=43)by random number table method.All patients in both groups received the first ultrasound-guided SAPB during surgery.At 24 hours postoperatively,patients in the SAPB group received a ultrasound-guided second SAPB,while patients in the control group were injected with an equal volume of normal saline at the same site.The quality of recovery-40(QoR-40)scores at 24 hours preoperatively,48 hours and 72 hours postoperatively,numerical rating scale(NRS)scores of pain at 24 hours,48 hours,72 hours postoperatively,sufentanil consumption within 48 hours postoperatively,and serum levels of interleukin-6(IL-6)and interleukin-10(IL-10),as well as the incidences of postoperative complications and adverse reactions were compared between the two groups.Results Variance analysis of repeated measures data showed significant differences in the groups,time,and interaction effects for QoR-40 total scores(P<0.05).Post-hoc tests revealed that the QoR-40 scores at 48 hours and 72 hours post-operatively in the SAPB group were significantly higher than those in the control group(P<0.05).Regarding pain control,the NRS scores showed statistically significant differences in group,time,and interaction(P<0.001).The NRS scores at 48 hours postoperatively and sufentanil consumption in the SAPB group were significantly lower/less than those in the control group(P<0.05).In terms of inflammatory response,the IL-6 levels at 48 hours and 72 hours postoperatively in the SAPB group were significantly lower than those in the control group(P<0.01),while the IL-10 levels were significantly higher than those in the control group(P<0.01).There was no statistically significant difference in the incidence of postoperative complications or adverse reactions between the two groups(P>0.05).Conclusion For patients undergoing thoraco-scopic surgery,performing ultrasound-guided second SAPB at 24 hours postoperatively can effectively prolong postoperative analgesia duration,improve postoperative recovery quality,reduce opioid consumption,alleviate postoperative inflammatory response,thereby promoting patient rehabilitation.